Thursday, 26 September 2013

I said on Twitter that I'd reply to this post by Dirk Hanson which claims to bust seven alcohol industry 'myths'. It is based on a passage from David Nutt's recent book Drugs Without the Hot Air. I haven't read that book yet but it doesn't surprise me to hear that he spends lots of time preaching against alcohol because that's what he always ends up doing.

Regular readers will know that I have mixed feelings about Professor Nutt. Some of what his says about drugs is sound, but his desire to be seen as the man who evaluates drugs in a cerebral, impartial and evidence-based manner is undermined by his frequent emotional and evidence-free outbursts.

So, the 'myths' are as follows:

1. Consuming Alcohol is Normal

87 per cent of the UK population drink alcohol. Virtually every society in the world has found a way to brew alcohol from some fruit or vegetable for thousands of years. Alcohol is deeply imbedded in all sorts of cultural and religious events from communion to Oktoberfest. It is a versatile drug that enriches people's lives in all sorts of contexts. All this has come about without the help of an alcohol 'industry' or advertising, because people very much enjoy drinking. Alcohol is normal.

It’s normal, so long as you have the “normal” high-activity variant of the ALDH2 enzyme. If you don’t have that form of the enzyme, Nutt reminds his readers, as many Asians and Aleuts do not, then alcohol will affect you quite non-normally through the so-called alcohol flush reaction. Moreover, many cultures and societies unfamiliar with its effects “suffer hugely when new types of alcohol appear, particularly if they are aggressively marketed.”

None of this changes what I have written above. It does not bust a 'myth'. It is, at best, a footnote that applies to some people from Asia and Alaska.

2. Alcohol damage is caused by a small group of deviants: According to Dr. Nutt, statistics show that “millions of people, NOT a tiny minority, suffer harm from their own alcohol consumption, or cause harm to others…. It is the everyday drinking of people who have come to see alcohol as an essential part of life rather than the luxury it used to be, that has created a spike in cancers and stomach problems, and will see liver disease match heart disease as the leading cause of death in the UK by 2020.”

In 2011, 4,765 people in England and Wales died from alcoholic liver disease. Other forms of liver disease (ie. not alcohol-related) killed 7,731 people. Meanwhile, 108,000 died from heart disease. 30,000 died from lung cancer. 11,390 died in accidents. 26,000 died from pneumonia. There is no chance at all that liver disease is going to be the leading cause of death by 2020. It's a ridiculous thing to say.

There has been no "spike" in cancer rates. They have risen steadily "mainly [as a] result of the UK's ageing population."

I was told recently by Nick Sheron that the average weekly alcohol consumption of a patient with alcoholic liver disease is 111 units. Presumably this is based on self-reported figures and is therefore an underestimate. Either way, these are clearly not your average moderate drinkers. David Nutt would have us believe that moderate drinkers are putting their lives at risk, because he believes the hoary old prohibitionist's tales about alcohol being (a) instantly addictive, and (b) toxic at any level. (I do not exaggerate, he said as much here.) In fact, there is a mountain of evidence showing that moderate drinking is healthy. Nutt dismisses this evidence out of hand.

I doubt the industry has ever used the word "deviant", but there is no doubt that there is a small minority of drinkers who drink a vastly disproportionate share of the nation's alcohol. Doctors and policemen see the same faces time and again. A sensible public health movement would target those people rather than the general population.

3. Normal adult non-drinkers do not exist: The alcohol industry is forever reminding politicians of how unpopular alcohol restrictions are to the voting populace. “The existence of non-drinkers obviously threatens this portrayal of society, so the industry tends to dismiss them as having something wrong with them. While some teetotalers are recovering alcoholics, many others have made a positive choice not to drink.” And there are others, I would add, often referred to as “sick” teetotalers, who have quit drinking for medical reasons unrelated to alcoholism.

I've never heard anybody, from the drinks industry or anywhere else, claim that normal adult non-drinkers do not exist. That which can be asserted without evidence can be dismissed without evidence.

4. Ignore alcohol’s harm to the body: Nutt reminds us that “there is no other drug which is so damaging to so many different organ systems in the body…. Most other drugs cause damage primarily in one or two areas—heart problems from cocaine, or urinary tract problems from ketamine. Alcohol is harmful almost everywhere.”

Ignoring something is not a statement and therefore cannot be a myth. Again, I challenge the author to find me an example of anyone in the booze trade who denies that alcohol can be harmful. While he's at it, he might like to ask someone from the anti-smoking lobby if they agree that "there is no other drug that is so damaging to so many different organ systems in the body."

5. Alcohol problems can be solved when everybody works together: “In practice, what the industry means by ‘working together’ is bring in voluntary codes rather than statutory regulation—solving problems through rules that the industry CHOOSES to comply with, rather than laws which they MUST comply with.”

Yes, that's what a voluntary code means. The author has not shown that this collaborative approach is less effective than the confrontational approach.

6. Alcohol marketing is intended to assist consumers in selecting products: Specifically, 800 million British pounds every year for advertising and promotion, according to Nutt. That’s just the kind of civic-minded bunch those alcohol sellers are. The reality, of course is that “marketing communications do have a marked effect on consumption…. All this further entrenches the false division between alcohol and illegal drugs, persuades people that consuming alcohol is safe, and makes realistic discussions of the harm alcohol causes very difficult.”

I genuinely pity people who say things like this. Not only do they dismiss the idea that advertising is about businesses persuading customers to switch to their brand, but they do it with the same sarcasm and superciliousness displayed above. As far as they're concerned, it is self-evident that the industry spends millions of pounds advertising the concept of drink to get people to drink more. Otherwise, what would be the point, eh? It's not like a business can make money out of a static or declining market by stealing sales from its competitors, is it?

I wonder if these bien pensants believe that businesses advertise products like margarine and washing powder in order to get people to buy more and more margarine and washing powder until their shelves are rammed with the stuff. Or would they concede that the intention is to get people to switch from Persil to Daz and from Flora to I Can't Believe It's Not Butter?

That's how advertising works most of the time. The exception is with brand new product categories where the advertising of one brand helps raise awareness of the product more generally and therefore lifts overall sales. E-cigarette advertising today is a good example of this. Alcohol is the opposite. It's been around forever.

Moreover, there is not a "false division between alcohol and illegal drugs". There is a very clear division. Alcohol is legal and drugs aren't. I would personally like to legalise drugs and Nutt, from what I can gather, would like to ban alcohol. Nevertheless, that is not currently the situation and it is perfectly consistent to allow the advertising of legal products but not illegal products.

Incidentally, the alcohol market in Britain has a turnover of about £40 billion so a marketing budget of £0.8 billion is hardly excessive.

7. Education about responsible use is the best approach: “It is useful for the drinks industry,” Nutt explains, “to emphasize the value of education, because it takes the focus off regulation…. There is also extensive evidence gathered by the WHO from around the world, showing that merely providing information and education without bringing in other policy measures doesn’t change people’s drinking behavior.”

I'm always amused by the way people in public health believe that commercial advertising is incredibly effective in controlling people's thoughts and actions, but their own health campaigns are utterly useless.

The success of an educational campaign should not be measured by how much it changes behaviour, but by how well-informed it leaves people. A well-informed population in a free society can do what it wants, regardless of whether it displeases people like Prof Nutt. People might decide to drink within the arbitrary, evidence-free limits set by public health mandarins (and most do) or they may decide that those limits are too low for their tastes and ignore them (as I do).

Who knows why alcohol consumption has fallen so much in Britain since 2002? Perhaps educational campaigns had some effect. It's hard to say. Certainly, it had nothing to do with advertising, of which there has continued to be plenty, nor did it have anything to do with availability, which has increased.

Wednesday, 25 September 2013

The latest in the long line of attempts to portray smoking as a drain on the economy/NHS/society appeared in Wales today. From the British Heart Foundation press release:

A new report published by ASH Wales - and part-funded by us - reveals that smoking costs the economy in Wales £790.66m a year.

The costs of smoking to the Welsh economy include:

£302 million spent on healthcare costs

£288 million lost to productivity through premature deaths

£49.5 million lost through excess sickness absence

£41 million lost to businesses through smoking breaks,

£25.8 million spent clearing up smoking-related litter

£45.4 million lost through premature death due to second hand smoke exposure

The aim of these reports is to pretend that the cost of smoking exceeds the massive amount of tax smokers pay. Several sneaky techniques are typically used to achieve this, several of which are on display here. For example, lost productivity from premature death would only realistically be a cost to the economy in a society where there is full employment. Few such societies exist, especially in Wales. Besides, economic output is measured per capita. It doesn't decline when people die.

The idea that smoking breaks cost the economy millions of pounds is a load of nonsense that was dreamt up in a notoriously pisspoor Policy Exchange report some years ago. A comprehensive study published recently showed this to be garbage (I wrote about it last month). As for the cost of passive smoking, the figure shown above is risibly high even if you swallow the dodgy assumptions upon which such estimates are based.

Above all, there is no attempt to balance the costs with the benefits. For example, if you're going to count lost productivity as a public cost (which it isn't—it's a private cost), you have to count savings in elderly healthcare, pensions, nursing homes etc which are overwhelmingly public costs. Reports like this never do so, but serious studies by economists find that these savings outweigh the costs—I list a few of them here, and there are many more.

All of this is run-of-the-mill junk economics from single-issue campaigners. It is designed to mislead, but it does not quite amount to an outright lie.

But then comes this...

The report also reveals that the cost of smoking to the economy as a whole is £145m higher than the amount generated by tobacco in tax every year, dispelling the myth that smoking benefits the economy.

What is wrong with these people? The government is not the economy, you muppets. Even if your figures weren't inflated and partial, they would not be a public cost to the state.

Look, ASH Wales, this is how it works. The government gets £600 million in tobacco taxes from Welsh smokers. The government then has to pay for the public costs of smoking. In practice—and ignoring the fact that your figures exclude the savings—this amounts to £302 million in healthcare costs and, at a push, £25.8 million for picking up 'smoking-related litter' (would the roads not otherwise be swept?).

The government therefore turns a tidy profit, which is hardly surprising considering that 80 per cent of the price of a pack of fags goes straight to the state. None of the other costs in this report involve the state having to shell out because—I'll say it again—they are not public costs and it is therefore entirely spurious to compare them with the revenue the state gets from smokers. This is such a basic schoolboy error that it makes you look ridiculous. Using this bungled thinking to claim that you are 'dispelling a myth' shows that you have no idea what you're doing.

Estimates of rates of problem gambling in Britain primarily come from three British Gambling Prevalence Surveys published by the Gambling Commission in 1999, 2007 and 2010. Each report uses two slightly different methodologies and found the following:

In 1999, it was estimated that 0.6% of the adult population were problem gamblers under the DSM methodology, with a confidence interval of 0.4-0.8%. Under the alternative measure of the South Oaks Gambling Scheme (SOGS), problem gambling prevalence was estimated to be slightly higher: 0.8% with a confidence interval of 0.6-1.0%.

The second British Gambling Prevalence Survey (2007) found similar rates: 0.6% under the DSM methodology (with a confidence interval of 0.5-0.8%) and 0.5% under the PGSI methodology (with a confidence interval of 0.4-0.8%).

The third and, as it transpired, final British Gambling Prevalence Survey in 2010 found a problem gambling prevalence of 0.9% under the DSM methodology with a confidence interval of 0.7-1.2%. Under the PGSI methodology, problem gambling prevalence was 0.7% with a confidence interval of 0.5-1.0%.

None of these figures differ greatly from the others. The confidence intervals are quite wide because problem gambling is relatively rare. The 2010 survey, for example, questioned 7,756 people but found only 64 problem gamblers. We must be wary of drawing firm conclusions on the basis of a handful of people and the authors of the British Gambling Prevalence Survey are right to refuse to pin problem gambling rates down to a tenth of one per cent. There is a 95% chance that the true figure falls somewhere within the confidence interval, but the researchers can be certain about little more than that.

Unfortunately, anti-gambling campaigners and the media are less respectful of statistical probity. Campaigners against fixed odds betting terminals have claimed that "problem gambling in the UK has increased by 50% in three years"—an assertion that is based on comparing the mid-point estimates from 2007 and 2010 under the DSM methodology. In fact, all of the figures reported in the three British Gambling Prevalence Surveys are consistent with Britain having a problem gambling prevalence of around 0.7%, which is low to middling by international standards.

Responsibility for collating problem gambling data has since been moved to public health departments in England, Scotland and Wales. The first of the new figures were published today in the Scottish Health Survey and they indicate that there has been no rise in problem gambling since 1999. Under both the DSM and PGSI methodologies, problem gambling prevalence in Scotland was found to be 0.7%, with similar confidence intervals of 0.5-1.1% and 0.5-1.2%.

The report notes that these figures are in line with previous surveys:

These 2012 estimates are similar to those observed for Scotland in the BGPS 2010, which estimated that 1.1% (DSM-IV) and 0.9% (PGSI) adults in Scotland were problem gamblers. The confidence intervals around the BGPS estimates were large due to small bases sizes for Scotland. The 95% confidence interval for the BGPS DSM-IV estimate was 0.4% - 2.8% and for the PGSI was 0.4% - 2.2%. This meant that we were 95% confident that the true estimate fell between these figures. The figures produced for the Scottish Health Survey in 2012 (0.7%) are well within this range and are not statistically different from the BGPS estimates.

If we used the campaigners' trick of looking only at the mid-point estimates, we could say that problem gambling has fallen by 40% in Scotland since 2010. That would be highly disingenuous, of course. We can only say that seven years after the last Labour government relaxed Britain's gambling laws—and twelve years after fixed odds betting terminals were introduced to betting shops—there is still no evidence of a rise in problem gambling prevalence.

Incidentally, the report also has smoking prevalence stats for Scotland. Figures for the last five years are as follows:

2008: 26%
2009: 25%
2010: 25%
2011: 23%
2012: 25%

I'm assured by one of the people who compiled this report that the rise between 2011 and 2012 was not statistically significant (surely they should increase the sample size?). That being so, there has been no significant decline in the smoking rate for some years despite the most intense burst of anti-smoking activity ever. Great success!

Monday, 23 September 2013

The question that often comes to mind when dealing with duplicitous politicians and pressure groups is 'are these people liars or are they just stupid?' They often provide ample evidence to support both options.

Soubry gave the committee the following story. She and her right-hand man, Andrew Black (Department of Health), felt that it was imperative for them to act unilaterally because they felt passionately about the legislation and were worried that it would pass to the Lithuanian presidency. They both believed that the Lithuanians would not pursue the TPD with as much zeal as the Irish and that—as Soubry said—"the moment was now". Soubry wasn't worried about the implications for e-cigarettes because e-cigarettes had been dropped from the Directive.

A couple of problems here. Firstly, e-cigarettes had not been dropped from the Directive (as the committee informed the squirming junior minister). Secondly— as she has recently revealed—there was no danger of the Lithuanians dropping the Directive. Indeed, they are pursuing it zealously as we speak.

Stephen Phillips: You also agree, as I understand it, with Mr Connarty that if the draft Directive had not been dealt with at that stage, it would have continued over to the Lithuanian presidency, yes?

Anna Soubry: If I may say, I do not think it is as simple as that. This was an important moment for us.

Stephen Phillips: Let us come back to why you believe a decision needed to be taken at that stage.

Anna Soubry: Good, because I would like the opportunity.

Stephen Phillips: As a matter of procedure, if no decision had been taken at that stage, the draft Directive would have been carried over to the Lithuanian presidency, yes?

Andrew Black: Mr Phillips, it was not a case of a decision being made or referred to another time. The Irish presidency put the issue on the agenda and drove forward the discussion. I think it was a matter for the Minister whether to take a proactive part. I do not think those discussions-

Stephen Phillips: Mr Black, I do not want to interrupt you, but I actually asked a different question. I do not mind whether you or the Minister answers, but as a matter of procedure, the draft Directive would have been carried over to the Lithuanian presidency. That is right, is it not?

Andrew Black: Yes, if they had picked it up.

Anna Soubry: If they had picked it up, but it would be a matter for the Lithuanian presidency.

Stephen Phillips: Therefore, Minister, in order to justify the decision to override scrutiny, you must demonstrate, must you not, that it was important to take a position, at the time that you did take a position, without abstaining. Can we agree on that?

Anna Soubry: Yes. I did not want to abstain.

...

Stephen Phillips: What indications had you had from UKRep, or any of your advisers, that either of those matters that led you to the view that you needed to take a decision at that stage would have shifted if the Directive had carried over to the Lithuanian presidency?

Anna Soubry: I did not think it would go over.I thought, "Now is the moment," and that was not just my view. It was also the view of my officials, and it was the view of all the Ministers I had had the opportunity to speak to. We were of the view that now was the moment.

Stephen Phillips: Why?

Anna Soubry: We did not believe that it would be taken over by the Lithuanians. We thought that the Irish had taken such a strong lead on it that this was the moment when the nettle needed to be seized. I do not think there were ever suggestions that the Lithuanians would have wanted to take it up. Now was the moment.

It is clear from this that Soubry's excuse for bypassing parliamentary scrutiny was that she felt that the TPD would not be taken up by the Lithuanians and would therefore perish. As a keen supporter of the Directive, she felt compelled to act hastily to prevent this happening. This is not a legitimate justification, but it is at least a reason.

"I am sorry that I did not accurately reflect the position of the Lithuanian Presidency on the Directive in my evidence and I would be grateful if a footnote, using the following wording, could be included in the corrected transcript at an appropriate place:

'During my evidence, I may have given the impression that the Lithuanian Presidency was not planning to prioritise the Directive. I have learned that the Lithuanians are keen to maintain the excellent progress on the Directive in Council made by the Irish."

Did she really not know the Lithuanians' intentions? If she didn't why didn't she find out? And why was she so confident when she spoke to the committee eight weeks ago? Does she act entirely on guesswork or is this just another shaggy dog story?

Incompetent or dishonest? You decide. Either way, surely not fit for office after this fiasco.

The campaign for plain packaging in Ireland moved forward in a predictable way last week with yet another yawnsome survey of kids being presented as exciting new evidence. As in numerous other previous efforts, children were shown cigarette packs and asked leading questions. Details of the 'research' are thin on the ground, but it is safe to say that the kiddies said they found the 'plain' packs less appealing than normal packs. As ever, this tells us nothing about what effect, if any, plain packaging will have on underage smoking prevalence. After all these years of tiresome campaigning for this daft policy, no one has presented a shred of evidence showing that people start smoking because of a colour scheme on a box.

Cigarette branding encourages teenagers to start smoking but non-smokers would be discouraged from even trying them and current smokers would quit if cigarettes came from ‘plain packs’, according to 15-16 year olds who participated in new research published today (Thursday, September 19th).

This is a straightforward lie. There is nothing in a survey of this kind that could possibly prove any of these three assertions.

Launching the research, Minister James Reilly said: ‘It is not acceptable that a product that kills 5,200 Irish people every year is packaged in a slim, pink container that strongly resembles perfume or lipstick.’

He's talking about cigarettes like those below, which are aimed at women rather than children. This is the standard picture of 'glitzy' cigs used by plain packaging lobbyists. It would be very interesting to know how many minors actually buy these brands. The eye-catching pack with the multi-colour cigarettes is called Sobrani Cocktail apparently. I know this because my mum remembers them from the 1960s. She's never smoked, but I smoked for twenty years and never saw them on sale. How many children smoke them? I would guess around zero.

How many children smoke the other 'glitzy' brands? That would be a research question worth asking. If young people are disproportionately more likely to buy cigarettes that 'strongly resemble perfume', that would be help the plain pack campaigners' cause. They have never conducted research of this kind and I suspect that the results would go against them. The reality is that minors who want to smoke will smoke whatever cigarettes they can get hold of.

The findings show that although finances and price prevent teenagers from purchasing premium brands of cigarettes, appealing packaging has the power to generate buzz, provide the incentive to purchase and can communicate perceived benefits of smoking one brand over another.

Hang on, what was that?

The findings show that although finances and price prevent teenagers from purchasing premium brands of cigarettes...

So the 'glitzy' packs are too expensive for kids to buy? What, then, is the point of plain packaging?

Barnardos Chief Executive, Fergus Finlay, said that the research shows that without regulation, children are being enticed to start smoking through colour, pack shape and text. “Children and young people find certain brands more appealing than others, whether it’s sports gear, phones, bags or make-up, and that’s because marketing works.”

That's how advertising works, perhaps. Brands are built up by advertising, but there is no advertising for tobacco and hasn't been for a very long time. Without advertising to create brand image, a logo is just a logo and a colour is just a colour.

“Cigarette companies know this and have become masters of marketing by using packets to make smoking appealing to children. Their success is evidenced by the fact that children start smoking in Ireland at a younger age than any other country in Europe.”

Are cigarette packs more 'glitzy' in Ireland than in the rest of the EU? Certainly not. Unlike most EU countries, Irish fag packets have large graphic warnings on them. Blaming Ireland's high rate of underage smoking on glitzy packets is a non sequitur.

Ms. Tanya Ward, Chief Executive of the Children’s Rights Alliance, said: “Whilst Ireland has been a world leader in protecting the health of adults from the effects of tobacco - most notably through the workplace smoking ban – much less has been done to safeguard children which may help explain why the Irish start smoking at a younger age than any of our EU counterparts."

The young age at which smokers in Ireland take up the habit seems to be the big statistic that plain pack advocates want to remind us of in this campaign. If they had a little self-awareness, they would realise that this is a damning indictment of all previous tobacco control measures. I've written before about the abject failure of tobacco control in the Emerald Isle. This is the country that has fallen hook, line and sinker for every half-witted anti-smoking policy put forward by the quackademics of public health. Despite this—or because of this—it has a high smoking rate, a massive black market in tobacco and the youngest smokers in the EU. This dismal failure should have been enough to force a rethink. Instead, they plunge towards ever more extreme policies that don't work because the people who come up with them don't understand the reasons why people smoke.

As an interesting addendum, I notice that this 'research' has not been published in any form. Indeed, according to yesterday's Sunday Times, it is being jealously guarded by this coalition of state-funded lobby groups.

The Irish Cancer Society said last week it received several phone calls from public relations agencies acting for tobacco companies seeking copies of its report on the impact of cigarette packaging.

...The society refused to hand over its research to “companies operating with a different agenda from ours”. It did not think it credible that callers claiming to be students would be seeking the report for research purposes on the day of its publication.

When would be more credible? A week before publication? A year after publication? What are they talking about?! The research should be published so that the public can see it. That's how science works. If you produce research designed to push your own 'agenda' and to guide policy, you should damn well have to show it to the people. Otherwise, we're liable to suspect that it's a piece of junk that doesn't stand up to the slightest scrutiny. If any readers come across this secret study, drop me a line.

Saturday, 21 September 2013

The moral panic about '24 hour drinking' has been revived this week for some reason. According to some copper in The Telegraph, a single instance of drunken behaviour requires seventeen officers and staff. As Timmy points out, this says more about the inefficiency of the police service that it does about Boozy Britain, but it acts as a springboard for a moan about one of the only decent pieces of legislation the last government introduced..

Mr Lee also attacked the previous Labour government's 24 – hour licensing regime, which has since been rowed back. He said the attempt to introduce a "café culture" had failed.

He said: "I think the café culture was an entirely legitimate experiment but I don't think it has worked."

It would be more relevant to say that the '24 hour licensing regime' failed to bring about 24 hour drinking. Round the clock availability remains confined to airports and a few hotels. If the Licensing Act has to have a nickname, it should be 'An Extra Hour Drinking (At Weekends, If You're Lucky)'.

I don't much care about café culture - a silly phrase Blair used to appeal to his bourgeois comrades in New Labour - but nor do I want to live under licensing laws that were dreamt up by David Lloyd George during the First World War. If we are to evaluate the 2005 Act, we should compare the hysterical predictions made by almost every newspaper with what actually happened. By almost every objective criteria, the panic merchants were absolutely wrong.

Only by misrepresenting the evidence can the press maintain their earlier narrative. The last paragraph of the Telegraph's report is a humdinger in this respect.

Between 30,000 and 40,000 people are fined for being drunk and disorderly each year, meaning more than a third of million since 24 – hour drinking was introduced in 2005.

The obvious implication is that the Licensing Act led to more people being arrested for being drunk and disorderly - and that this is all terribly expensive - but we are not given sufficient information to draw any such conclusion. Had the Telegraph bothered to compare the number of offences for drunkenness before and after 2005, they would have seen the full picture. Figures below show the number of drunkenness offences in the UK, including cautions and convictions (from the BBPA Statistical Handbook, 2012: p. 84).

These figures go back to 1965 when the total was 80,969. The peak year was 1980 when there were 124,380 recorded offences. That works out as a rate of 27.8 per 10,000 adults. By 2010, that rate had fallen to just 4.8 per 10,000 adults.

You can argue that much of this decline is the result of the police being more lenient, not doing their job properly or arresting people under some of the many other laws they have at their disposal. Certainly it seems highly unlikely that the huge drop between 2003 and 2005 was due entirely to 'revellers' (as the press invariably term them) being better behaved. You can also argue that these revellers would be better behaved if the police made more arrests for public drunkenness. I am sympathetic to both arguments.

But what you cannot say is that there has been a surge in the number of people being arrested for drunkenness and that this has put an immense strain on police resources. The facts are clear. Arrests for drunkenness have fallen since so-called 24 hour drinking began. It is meaningless to say that there have been "more than a third of a million" such offences since 2005 (aside from the fact that there actually haven't) without putting it in the context of the 1970s when there were a third of a million such offences every three years. Back then, of course, it wouldn't have required seventeen state officials to carry each of them out.

Friday, 20 September 2013

I nearly posted this news from Florida earlier in the week, but it seems particularly apt now...

State officials lift tobacco ban in prison work camps

TALLAHASSEE -- Corrections officials quietly reversed a blanket ban on tobacco at prisons this summer and are now allowing inmates at work release centers to have up to 10 packs of cigarettes each.

Department of Corrections officials say they lifted the prohibition on tobacco-related products in the work release programs because they didn’t want prisoners so close to completing their sentences to have to go back behind bars for breaking the rules.

...The switch comes less than two years after DOC made all tobacco-related products off-limits at prisons, work camps and work release centers on Sept. 30, 2011.

“The decision to eliminate smoking and tobacco use was made to reduce the medical cost associated with exposure to tobacco, and eliminate secondhand smoke exposure to non-smokers,” the agency said in April 2011, when the ban was announced. The ban also applied to prison workers, who are not allowed to bring cigarettes into facilities, and to visitors. Death Row prisoners are allowed to buy two packs of smokeless tobacco products per week [harm reduction for the condemned - nice touch! - CJS].

The federal Bureau of Prisons and more than half of the other states also ban tobacco in prisons, but the prohibitions have created a new demand for cigarettes, a valuable commodity behind bars. According to some reports, inmates in New York City jails are paying up to $200 for a pack of smokes.

During a six-month period shortly after the Florida ban went into effect, nearly 30,000 inmates or prison workers were caught with some sort of tobacco contraband, according to DOC’s annual report.

Prohibition doesn't work - even in prison. Nevertheless, it is reported today (as it was in March) that the British government plans to introduce a total smoking ban in prisons in the next two years. At the moment, prisoners can only smoke in their cell - smoking is banned in communal areas - and nonsmokers are not forced to share a cell with smokers.

Prisons were originally exempt from the 2007 Health Act on the basis that they are the homes of inmates. The Prison Service also warned that a ban would lead to more assaults on staff. This sounds entirely reasonable. Too reasonable, indeed, for the unappeasable health lobby. As usual, secondhand smoke is being used as the excuse for more draconian rules, but the fact that smoking will also be banned in outdoor areas and exercise yards - and that smokeless tobacco will also be included - shows that it's not really about passive smoke and it's not really about health. But then, it never is.

Wednesday, 18 September 2013

Sugary drinks would be banned and a tax slapped on all sugar-sweetened drinks under a proposal by Auckland University researcher Gerhard Sundborn, to be presented at the Public Health Association conference today.

In a first step to combat the obesity epidemic, Dr Sundborn said the prolific consumption of sugar-sweetened drinks should be tackled by the Government in a sugar-free strategy, with drinks regulated in the same way tobacco had been.

"These beverages are harmful and very addictive, and these companies look at getting our children hooked. They don't have any nutritional value in them at all, and a huge amount of sugar, caffeine and flavourings."

An end-game strategy could see the advertising and sale of sugar-free drinks regulated and replaced by healthier artificially sweetened drinks, or water and milk.

Keep yapping, 'health experts'. Let it all out. Only by hearing what you really think will the public realise that everything we've said about your endless, obsessive, puritanical crusade for lifestyle regulation is true.

Tuesday, 17 September 2013

Soft drinks should carry tobacco-style warnings that sugar is highly addictive and dangerous, a senior Dutch health official has warned.

Paul van der Velpen, the head of Amsterdam's health service, the Dutch capital city where the sale of cannabis is legalised, wants to see sugar tightly regulated.

"Just like alcohol and tobacco, sugar is actually a drug. There is an important role for government. The use of sugar should be discouraged. And users should be made aware of the dangers," he wrote on an official public health website.

"This may seem exaggerated and far-fetched, but sugar is the most dangerous drug of the times and can still be easily acquired everywhere."

... "Sugar is actually a form of addiction [sic]. It's just as hard to get rid of the urge for sweet foods as of smoking. Thereby diets only work temporarily. Addiction therapy is better."

The senior health official wants to see sugar taxes and legal limits set on the amount that can added to processed food. He also wants cigarette-style warnings on sweets and soft drinks telling consumers that "sugar is addictive and bad for the health".

"Health insurers should have to finance addiction therapy for their obese clients. Schools would no longer be allowed to sell sweets and soft drinks. Producers of sports drinks that are bursting with sugar should be sued over misleading advertising and so on," he said.

This is wonderful stuff. Who needs liberal critics to warn of slippery slopes and fanaticism when all you have to do is put a microphone in front of these people and let them speak their mind?

More of this kind of thing please, 'public health professionals'. Keep talking until the whole world can see what you're all about.

Courtesy of Vapour Trails TV, this is a film of a recent debate about e-cigarettes held in London recently.

If you have the time, watch the whole thing. If you're pushed for time, I particularly recommend watching Martin Dockrell (ASH) at 23.30, Clive Bates (ex-ASH) at 49.50 and David Dorn (Vapour Trails) at 59.30.

Friday, 13 September 2013

I was on the Irish radio station Today FM yesterday debating with a spokeswoman from the Irish Cancer Society. It appears that the Irish anti-smoking lobby has picked up on an idea that Anna Gilmore came up with three years ago. I wrote about it at the time in a post entitled You Can't Rip Smokers Off, That's Our Job. The gist of Gimore's argument is that the tobacco industry makes 'excessive profits' and therefore (?!) the government should tax cigarettes more.

The Irish government actually makes fourteen times as much money from cigarettes in Ireland than the tobacco industry does, so if we're going to accuse anyone of excessive profiteering I would suggest that the industry comes a very distant second after their venal politicians.

Wednesday, 11 September 2013

The 'let's ban alcohol advertising from sports' story (see previous post) has now been covered by the BBC. It appears in the Science/Environment section rather than the Health section, which seems weird until you see that it was written by Suzi Gage. Some readers will remember Ms. Gage from her attempt to smear a scientist on The Guardian website in January because—in her opinion—his findings were "a gift to those who would like to prevent attempts to reduce levels of smoking". The scientist crushed her in the comments and later wrote that "the headline was an affront to my professional reputation as a researcher and the post was an affront to the perceived quality of the Guardian."

Apparently these are the qualities the BBC looks for in a journalist and so Gage now writes for its Science/Environment webpages. Science reporters—as opposed to health reporters—don't generally do puff pieces for 'public health' lobbyists, but Gage has managed to crowbar this bit of policy-based evidence in. And, to be fair, she gives someone from the alcohol industry a brief right to reply...

A spokesman for the Portman Group told BBC News: "National trends around alcohol consumption are encouraging. Government figures show that fewer and fewer children are even trying alcohol and the number of adults that drink to harmful levels is also falling.

"The drinks industry is committed to responsible marketing practices in all forms to help continue these positive national trends."

This voice of reason is vastly outnumbered by an array of researchers-cum-campaigners demanding a ban. First, we hear from the study's author who goes into a diatribe about how dreadful alcohol is. The following is only a snippet...

"Alcohol causes such a large range of problems, a range of health problems from sore head the next morning to deadly liver disease.

"It also causes a really wide range of social and, with knock-on effects, economic problems. From things like people who get pregnant when they're drunk because their judgement is diminished to people who lose their family and their jobs because of alcohol," said Dr Adams.

Gage then adds her own opinion, subtly presented as fact...

Dr Adams is concerned about the amount of brand information that is presented outside traditional commercials, as this is often less noticeable, yet still has an effect of biasing people's attention towards alcohol.

Then it's the turn of a seemingly random academic from the ubiquitous University of Bath...

Dr Sally Adams (no relation) is a research psychologist specialising in alcohol studies, from the University of Bath, and was not involved in the study.

She told BBC News: "Alcohol-related cues are often processed outside of an individual's awareness and can stimulate thoughts, memories and expectations of alcohol. In turn these thoughts can lead an individual to seeking out and consuming alcohol.

"In a nutshell, alcohol-related cues can bias our thoughts and behaviours to be targeted towards alcohol and drinking."

Then we really get down to brass tacks with some overt slippery slope logic...

The authors believe their findings have implications for the current state of alcohol regulation. First author Andy Graham, a speciality registrar in Public Health, told a press conference at the British Science Festival: "We believe a similar restriction to that imposed on tobacco products may be justified."

The same theme is picked up by the last pro-ban spokesperson...

Prof Matt Field from the University of Liverpool, also uninvolved in the study, told BBC News: "Not so long ago, tobacco advertising was plastered all over racing cars and snooker venues. That has since been banned and perhaps we need to do the same for alcohol and sport, if it's a way of introducing beer to young people."

So that's five people in the article who are in favour of a ban—if you include Gage, as you should—versus one unnamed booze industry rep against. Fair and balanced?

Take note of what is being argued here, by the way. The authors want legislation because they are concerned about the references to alcohol and alcohol brand names being seen and heard, even if only briefly, because they supposedly have the "effect of biasing people's attention towards alcohol". It is far too early for them to take this logic to its natural conclusion and demand display bans and plain packaging, but be under no illusion that that is where their logic will take them.

Last week I mentioned that the Australians have finally admitted that the Total Consumption Model—which says, to put it simply, that heavy drinking falls in line with per capita consumption—is not supported by real world evidence.

Today, the Guardian reports that 'Alcohol marketing in TV football should be restricted, say scientists'. The [cough] scientists in question sat around watching football matches for 18 hours and counted how many times they heard or saw a reference to alcohol. There were obviously quite a lot, especially in the Carling Cup and Budweiser FA Cup. Needless to say, the conclusion is that the temperance lobby should continue following the anti-smoking blueprint and start banning this kind of sponsorship.

“We believe a similar restriction to that imposed on tobacco products may be justified.”

So far, so predictable. I mention it only for something that appears in the press release for the study, but didn't make it into the Guardian article.

Dr Jean Adams, senior lecturer in public health at Newcastle University and a member of Fuse, the Centre for Translational Research in Public Health, said: “Alcohol–related hospital admission are continuing to rise, despite alcohol consumption falling overall because the heaviest drinkers are consuming more."

And so, the belief that is fundamental to all neo-temperance policies and is fundamental to the Sheffield minimum pricing model*—that reducing per capita consumption reduces heavy drinking and harm—has been shown to be baloney.

Once again.

Time for a rethink?

* [UPDATE: John Holmes from the Sheffield Uni team has said on Twitter that they based their estimates on subgroups, not mean consumption. Wild horses wouldn't get me to trudge through the Sheffield study again so I will take his word for it for the time being.]

Sunday, 8 September 2013

A study published by The Lancet today confirms that e-cigarettes are at least as effective as nicotine patches for people trying to quit smoking.

In a randomised controlled trial, subjects were given e-cigarettes or nicotine patches. The abstinence rate after 1, 3 and 6 months were as follows:

Another group of subjects was given nicotine-free (placebo) e-cigarettes. Their abstinence rate after 6 months was 4.1%. In sum, the 6 month abstinence rates were highest amongst the e-cigarette group (7.3%), followed by the patches group (5.8%) and the placebo e-cigarettes (4.1%).

The abstinence rate amongst e-cigarette users is lower in this study than in a couple of recent studies. The researchers suggest that this may be because the e-cigarette group was given one cartridge a day which was the equivalent of only 20% of the normal nicotine intake of a smoker. Whatever the reason, this study shows that e-cigarettes appear to meet the minimal condition of being at least as effective as nicotine patches.

"The quitting rates were about 25 per cent better than patches for the e-cigarettes, but statistically we're more confident with saying that they were comparable, rather than superior," says Bullen.

The study also finds that smokers find e-cigarettes more appealing and are much more likely to recommend them to their friends than patches. Amongst those who failed to give up entirely, a third of e-cigarette users were still using them after 6 months (and had cut down their cigarette intake) while only one in ten of the patches group were still using patches.

The study is accompanied by a sound commentary by Peter Hayek who addresses all the usual scare-mongering objections of e-cigarettes' opponents (who are surely busy right now looking for flaws in the study), such as their wibble about 'gateway effects' and 'renormalising' smoking. He also explains the importance of keeping the e-cigarette market free and innovative—which will not happen if it is subjected to heavy-handed medical regulation.

The key message is that in the context of minimum support, e-­cigarettes are at
least as effective as nicotine patches. E­-cigarettes are also more attractive than patches to many smokers, and can be accessed in most countries without the restrictions around medicines that apply to nicotine replacement therapy or the costly involvement of health professionals. These advantages suggest that e­-cigarettes have the potential to increase rates of smoking cessation and reduce costs to quitters and to health services.

The main untapped potential of e-­cigarettes, how­ever, might not be in treatment of the minority of smokers seeking help with quitting, but rather as a safer consumer product for use by smokers in general. Such use could ultimately lead to the disappearance of combustible tobacco products and to the end of the epidemic of smoking-­related disease and death. To rival cigarettes in providing what smokers want, e-­cigarettes need to develop further, but under the pressure of market competition, they are currently undergoing a fast evolution and are likely to keep improving.

Concerns have been expressed that rather than reducing or even replacing traditional smoking, e-cigarettes could increase smoking rates by attracting new recruits and reducing quit attempts. This situation is usually implied by the phrase “renormalising smoking”. Such an outcome seems counter­-intuitive and contradicted by the present study and by other data currently available, but it is theoretically possible. There is an obvious source of evidence as to whether use of e-­cigarettes leads to an increase or reduction in tobacco smoking: the trajectories of sales of e-­cigarettes and tobacco cigarettes.

If growing sales of e-­cigarettes coincide with increased sales of tobacco cigarettes, tobacco control activists arguing for restriction of e-­cigarette availability would be vindi­cated. If traditional cigarette sales decline as e-­cigarette sales increase, it would suggest that e­-cigarettes are normalising non­smoking and that it is in the interest of public health to promote and support their development rather than try to restrict it.

The European Union and UK are currently proposing to regulate e-­cigarettes as medicinal devices, while leaving cigarettes available on general sale. If this regulation goes ahead, tobacco cigarettes will retain their market monopoly and we will never learn whether e-­cigarettes would replace traditional cigarettes if allowed to continue evolving and competing with smoked tobacco on even terms.

The Lancet is usually very statist and illiberal so it's nice to see a bit of common sense in its pages for once.

I'll put the link to the study and commentary up as soon as it goes live.

Top fact from @ReframeKENT - Dry cleaning is the only industry to have been adversely affected by the smoking ban
— ASH Wales (@ASHWalesCymru) September 7, 2013

It certainly didn't hurt the hurt the tobacco industry, but the pub, club and bingo industries might have something to say about that.

Meanwhile, ASH Wales' Scottish counterparts are hopping mad about Celtic football club - brace yourself - allowing people to use e-cigarettes in their stadium. They're even selling them. Oh, the humanity!

Sheila Duffy, chief executive of Ash Scotland, said: "I am disappointed by the Celtic decision. Electronic cigarettes are much safer than tobacco, but they are produced by companies whose profit is money...

OMG, businesses are run for profit! Why can't they rely on hand outs from the taxpayer like ASH?

Can we crowbar in a reference to the tobacco industry?

"E-lites is not owned by a tobacco company but the tobacco companies have an interest in promoting dual use."

Yes we can!

Stewart Maxwell, MSP for West of Scotland, said: "I am very disappointed an extremely big and successful football club such as Celtic would get involved with this type of sponsorship deal.

"The whole campaign to ban smoking in public places was about de-normalising smoking as an activity in public."

I thought the smoking ban was to 'protect' bar staff from secondhand smoke. Thanks for clearing that up, Stewart.

Thursday, 5 September 2013

This study about graphic warnings has been getting a fair bit of coverage today, including from BBC online and The Scotsman. From the latter...

Teenage smokers ignore cigarette warnings

Picture and text warnings on the back of cigarette packets depicting the dangers of smoking have little impact on teenage smokers, a Scottish study suggests.

Researchers at Stirling University found that the graphic images and words were particularly ineffective in targeting teenagers who are regular smokers.

... Half the respondents in both surveys said they had “often” or “very often” noticed the warnings, and around one in five had very often read or looked closely at them.

But the percentage of regular smokers who noticed them fell from 77 per cent in 2008 to 66 per cent in 2011.

The graphic warnings were introduced in 2008, so a drop in the number of smokers who noticed them does not exactly constitute a roaring success.

Sterling University's Centre for Tobacco Control Research—for it was they who did the study—damned graphic warnings with the faintest of praise...

"Positioning pictorial warnings only on the back of packs may have had a deterrent effect on never and experimental smokers, but for most measures no significant differences were observed.

The impact on regular smokers was negligible."

The study is co-authored by our old friend Gerard Hastings, but even he was not able to polish this turd of a result. It's published in Tobacco Control so there are some attempts to portray the results in a positive light, but it's an uphill struggle and in the end, the authors don't really bother. Instead, they hope that the miserable failure of their last bright idea will encourage politicians to adopt their next bright idea—plain packaging. It's the usual story that is especially familiar to the people of Ireland— ie. "that didn't work so let's do more of it".

Graphic warnings are old news. We've had them in Britain for several years. No one seems to be particularly interested in whether they worked or not. The anti-smoking lobby has long since moved on to display bans and vending machine bans and the plain packs nonsense.

But we should be interested. It's not that long ago since graphic warnings were being pushed with the same fervour as plain packs are today.

Back in 2008, Deborah Arnott was pitching them as 'evidence-based' weapons against smoking...

Deborah Arnott, director of anti-smoking campaign group Ash, added: "The introduction of picture warnings on tobacco products is a strong visual reminder of the horrendous illnesses caused by smoking and the evidence is that they work."

The British Medical Association said: "Placing graphic images on cigarettes packaging showing the horrible ways in which smoking can damage your health will undoubtedly encourage some people to give up smoking"

Except they didn't. As so often in tobacco control, the campaigners conflated "evidence" with "things we keep saying over and over again".

A comprehensive study from Canada, the first country to introduce pictorial warnings, found that “the warnings have not had a discernible impact on smoking prevalence.” A similar study in Britain found that those who saw the warnings said that it put them off smoking, and some smokers said that it made them think about quitting, but when it came to actually increasing the quit rate, the warnings made no difference (does this sound familiar?). As the researchers noted: “With the exception of an increase in avoiding the messages, there were few behavioural changes post implementation of the pictures.” They continued:

There were few changes post implementation of the picture health warnings in the number of health effects recalled or participant’s perception of risk... There were no differences post implementation of the picture health warnings in the number of smokers reporting forgoing a cigarette when about to smoke one or stubbing out a cigarette because they thought about the health risks of smoking... Among young people, the impact of picture health warnings was negligible.

Graphic warnings were a damp squib, as this latest study from Hastings et al. confirms. The gulf between what anti-smoking campaigners promise and what actually happens when governments capitulate to their demands deserves more attention than it receives. It is worth bearing their track record in mind next time you hear them wittering on about "overwhelming evidence" and how policy X is going to deter young people from taking up smoking.

Wednesday, 4 September 2013

New research from Australia shows that total alcohol consumption has been falling but heavy drinking has been rising. This flies in the face of the Total Consumption Model so beloved of 'public health' campaigners. I've written a blog post about it for the IEA here. Do go have a read of it.

Tuesday, 3 September 2013

Look at the picture above. It shows a wall at Cardiff Airport where photos of various members of staff are displayed.

The wall doesn't look like that any more. Thanks to one monomaniac, the photo of the lady who works in the shop has been removed. Why? Let's hear it from the horse's mouth...

That's right, a photo of a shopkeeper is now an "advert for the tobacco industry". ASH Wales were straight on the case...

One wonders what kind of sheltered life someone has to lead for them to be "genuinely shocked" by a picture of a woman behind a till in what looks like millions of other normal corner shops. Are these people for real?

Incredibly, ASH Wales not only pursued this unhinged complaint, but Cardiff Airport complied...

There are no words. I don't what is more depressing—that someone would find this image "genuinely shocking" or that the airport officials didn't laugh in ASH Wales' faces when they made their vexatious complaint. Truly, the lunatics have taken over the asylum. #Victory indeed.

Ministers should tax unhealthy foods, experts urge today, as they warn that nearly half of all adults in Britain will be obese by 2030

In the end, the government didn't tax 'unhealthy' foods. Instead they worked with industry on a voluntary agreement that the public health authoritarians hated. Most of those authoritarians have subsequently thrown their toys out of the pram and stormed out of the room.

So what happened next? Did obesity rates continue to spiral? Are we still on course for having a male obesity rate of 48 per cent in 17 years time?

Adults in Britain have stopped getting fatter after years of rising obesity rates, a new study has shown.

The study that has inspired this headline is only catching up with what the rest of us noticed a while ago—that rates of obesity in Britain started levelling off ten years ago. The "half will be obese by 2030" prediction came from a 2011 study in The Lancet which ignored the trend of recent years to produce a policy-based prediction that never looked credible.

The central claim of that study (which I wrote about at the time) was that 48 per cent of men would be obese by 2030. But if one looks at the male obesity rate in England since the turn of the millennium (below), nothing in the current trend suggests that obesity will rise to anything like that level (the female obesity rate shows a similar picture).

The trick The Lancet pulled was to extrapolate from the data of the 1980s and 1990s—when the obesity rate undoubtedly did rise significantly—while ignoring the current trend which is nearly flat since 2000 and completely flat since 2006.

There is, in any case, no reason to assume that obesity rates will rise in a linear way, but even if there was, there's no reason to think that historic data are a better guide than recent data.

Although it's too early to say for sure, The Lancet's prediction looks like being just another in a long line of vastly inaccurate obesity forecasts which are quietly forgotten when prophecy fails. Back in 2006, for example, it was predicted that 33 per cent of men would be obese by 2010. Currently, the male obesity rate is 23.6 per cent—which is exactly what it was in 2006. It's going to have to double in the next 17 years for The Lancet prediction to be correct. Considering that the rate has increased by just 2.6 percentage points since 2000—and by zero since 2006—that seems a tad unlikely.

About Me

Writer and researcher at the Institute of Economic Affairs. Blogging in a personal capacity.
Author of Selfishness, Greed and Capitalism (2015), The Art of Suppression (2011), The Spirit Level Delusion (2010) and Velvet Glove, Iron Fist (2009).

"Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience."